by Alison O'Donoghue

Created on: December 28, 2008   Last Updated: February 22, 2012

You might be surprised to discover that, every year, over half a million Americans suffer a closed-head injury which is serious enough to require admission to hospital. Millions more sustain minor head trauma and may or may not seek medical advice. Closed-head injuries are by far the most common type of head injury as their name suggests, the skull remains intact, but the delicate brain within is damaged. Common causes of closed-head injuries are motor vehicle collisions, falls, physical assaults, or accidents in the home, workplace or while playing sports. Soldiers serving in combat zones may also be at risk of closed head injuries from bomb blasts.

Serious closed-head injuries usually receive rapid medical attention, but milder injuries which account for up to 75% of the total frequently do not. There are a number of reasons why this may occur. For instance, younger people may delay seeking treatment because they are unsure about the significance of their symptoms, unfamiliar with accessing health care, or worried about having sustained an injury during risk-taking activities. Older people may attribute their symptoms to the aging process or may delay seeking help because of inadequate medical insurance or fear of the consequences of reporting a fall or accident.

Even when a person seeks medical help, a closed-head injury may remain undiagnosed, especially if no direct impact to the head occurred, or if there is no visible wound. For instance, someone in a car which is hit from behind may find their head is sharply rocked back and forth although no external injury occurs, the brain follows the movement of the skull and nerve fibers and blood vessels may be stretched, twisted or even torn.

As the symptoms and signs of closed-head injury can overlap with those of other conditions, they may be misdiagnosed. Common early symptoms are headache, dizziness, light-headedness, vomiting and memory disturbance. There may or may not have been a short period of loss of consciousness. The person's speech may be slurred, their vision may be blurred and they may be confused and unable to answer questions appropriately. These symptoms and signs may be misdiagnosed as acute intoxication with alcohol or drugs or, in elderly persons, as dementia.

Sometimes, there may be no symptoms or signs immediately after the closed-head injury, but these may appear gradually over a period of days, weeks and even months, as a result of swelling of the injured brain. Some of these symptoms

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